AMH & Ovarian Reserve
What is the Anti-Mullerian Hormone (AMH)?
Anti-Mullerian Hormone (AMH) is a hormone that’s secreted by the tiny cells in your developing egg sacs that could potentially grow an egg. The level of AMH in your blood is considered a good indicator of your ovarian reserve: the number of eggs you could produce.
How is AMH tested?
AMH levels can be measured in your blood, and it is mostly unaffected by timing of your menstrual cycle. However, it can be affected by hormone use, so it’s really important to let your fertility specialist know if are using any hormonal contraception.
Can I still fall pregnant with a low AMH score?
The short answer is yes.
There is a lot of media hype around low AMH levels, pushing people into IVF unnecessarily. Young women are scared into thinking they can’t conceive before they have even started trying! And so they get their AMH tested, sometimes repeatedly. But actually, it doesn't matter whether your AMH is 1 or 20. If you take two women who are exactly the same age, for example they’re both 30, and everything else about the health and fertility status is the same, their chances of conceiving next month are exactly the same - regardless of their AMH level!
“A lot of women have their AMH tested before they've even started trying to conceive, and come to see me very worried about their score . But quite often it's ok!” Dr I-Ferne Tan
While a low AMH score might sound scary because it means you don’t have as many eggs left, it’s generally not a problem. The reason is simple: every month, you only ovulate one egg (2 on the rare occasion), regardless of how many potential eggs you have. And the fact remains: you only need one egg to fall pregnant.
When should I check my AMH levels?
“I use an AMH level to guide and tailor my treatment plans for patients undergoing IVF.”
Dr I-Ferne Tan
Are there alternatives to AMH to check ovarian reserve?
An Antral Follicle Count (AFC) is an ultrasound assessment of premature eggs in your ovaries. While it gives similar information, this result can vary much more throughout your cycle, and therefore is less reliable than a blood test for AMH levels.
AMH is valuable tool for a fertility specialist, but it must be interpreted and used with caution. It doesn’t predict your chances of pregnancy, but can help to guide your fertility journey and treatment options. If you have had an AMH test and have concerns or questions about your results, contact your fertility specialist to discuss how it applies to your unique situation.
When it comes to IVF, it’s a little different…
In an IVF cycle, there can be a fine balance between maximising the number of mature eggs produced and severe complications such as hyperstimulation (OHSS). Ideally, you want to produce 10 to 15 eggs in an IVF cycle. This range is associated with the highest pregnancy success rates. I use an AMH level to guide and tailor my treatment plans for patients undergoing IVF. However, if you have a low AMH, realistically you are unlikely to achieve this many eggs. So an AMH level can help guide our expectations on the number of follicles and eggs we are likely to achieve with each cycle, helping you make informed decisions about your treatment.
If you are considering egg freezing, an AMH level can help you decide on fertility preservation treatment since we know that egg numbers and quality will only decrease with age.